NEWS

Threat of blood clots explored in UNC public education seminar

CHAPEL HILL -- Dr. Stephan Moll says he has received calls from as far away as Mississippi and Michigan, from people starved for information on blood clots: the risks, the symptoms and the most promising treatments.

These calls, and recent research advances, have made Moll and his colleagues even more determined to make others aware of the risks posed by blood clots. Moll, director of the thrombosis program at the University of North Carolina at Chapel Hill School of Medicine’s Center for Thrombosis and Hemostasis, will speak at an Oct. 8 public education seminar on "Blood Clots: Your Genes, Your Risk."

The free seminar will be held 7 p.m. to 9:30 p.m. at UNC’s William and Ida Friday Center for Continuing Education. Liz Hellman, a genetic counselor from Kansas City, also will speak. Registration is not required, but those who wish to register may call (919) 843-2568 or click on www.unchealthcare.org.

Deep-vein thrombosis, also called DVT, affects one in 1,000 people, with 12,000 deaths per year from pulmonary embolism. Although the risk of clots increases with age, DVT and embolism can strike anyone with little warning, said Moll. Experts don’t know the true rate of DVT, he added, because clots are frequently misdiagnosed as Charley horses, muscle sprains or muscle tears.

"At the moment, patients with clots are seen by any physician: by internists, hematologists, gynecologists and orthopedists," Moll said. "They all know a little about clots but don’t see so many of them. So the diagnostic ability may not be very high.

"The decision to treat clots with blood thinner, the counseling on testing and hormone replacement therapy – if over a two-year period you only see one or two patients with clots, you may not be as well-versed as you need to be."

Moll said the best solution would be thrombophilia centers, which would offer comprehensive care to patients with a variety of blood clots and coagulation disorders, lead clinical trials and offer genetic counseling. Until recently, he said, federally funded thrombophilia centers didn’t exist.

"The consequence is suboptimal care for patients with thrombophilia and a lack of thrombopilia research."

That has changed since October 2001, when the U.S. Centers for Disease Control and Prevention designated eight thrombophilia pilot sites in the nation – including centers at UNC and Duke University Medical Center. Dr. Gilbert White, director of the Center for Thrombosis and Hemostasis, is principal investigator for UNC’s two-year CDC grant.

As a part of the CDC initiative, Moll is coordinating work to identify women with clotting disorders who may benefit from blood-thinning medication during pregnancy. In particular, Moll said, he wanted to understand the role blood clots play in causing fetal death or spontaneous abortions, a link suspected but not yet established by research.

Several studies involving UNC researchers are aimed at improving treatments for blood clots.

The PREVENT study focuses on coumadin, a standard blood-thinning medication doctors use to treat patients during the first six months after a blood clot is diagnosed but that also has been associated with high incidence of side effects. The study involves one group that receives no more coumadin after the first six months but instead receives an inactive compound.

The second group will follow the six months’ regular treatment with a lower maintenance dose of the drug.

The THRIVE V study is in the final stage before U.S. Food and Drug Administration approval and focuses on a new medication for treating blood clots that doesn’t require the monitoring that coumadin does.

Another just-completed study centers on patients with malignancies who develop blood clots.

For more information on DVT, click on www.bloodclot.org or www.fvleiden.org.

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Center for Thrombosis and Hemostasis contact: Margo Price, (919) 966-6011